Provider Demographics
NPI:1386702454
Name:CHANDLER, DAYLENE (MS, ATC)
Entity type:Individual
Prefix:
First Name:DAYLENE
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:DAYLENE
Other - Middle Name:
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:18798 E 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8290
Mailing Address - Country:US
Mailing Address - Phone:720-363-2450
Mailing Address - Fax:
Practice Address - Street 1:410 OUACHITA ST
Practice Address - Street 2:OBU BOX 3732
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71998-0001
Practice Address - Country:US
Practice Address - Phone:870-245-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT 2412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer